Soluble tumor necrosis factor-α receptor type 1 during selenium supplementation in psoriasis patients

Abstract

Objective Tumor necrosis factor-α (TNF-α) and its receptors play important roles in the induction and maintenance of psoriatic lesions. Selenium (Se), a trace element with immunomodulatory properties, is usually decreased in psoriasis patients. We examined the influence of Se supplementation on soluble TNF-α receptor type 1 (sTNF-R1) and topical treatment in psoriasis patients. Methods The study was conducted in between January and June 2002. Twenty-two inpatients with active plaque psoriasis received topical treatment with 5% salicylic acid ointment, 0.1% to 0.3% dithranol ointment, and 200 μg daily of Se as selenomethionine (SeMet; n = 11, group 1) or placebo ( n = 11, group 2) for 4 wk. Psoriasis Area and Severity Index (PASI) score and Se and sTNF-R1 concentrations were assessed at baseline and every 2 wk. Control sera were obtained from 10 healthy subjects. For statistical analysis, parametric tests were used, and the level of significance was set at P = 0.05. Results The baseline sTNF-R1 levels were 1.87 ± 0.58 ng/mL (1.98 ± 0.44 ng/mL in group 1 and 1.75 ± 0.69 ng/mL in group 2, P = 0.34) in psoriasis patients and 1.65 ± 0.25 ng/mL in control subjects ( P = 0.17); baseline Se concentrations were 48.31 ± 13.20 μg/L (48.31 ± 13.20 μg/L in group 1 and 50.35 ± 13.49 μg/L in group 2, P = 0.41) in psoriasis patients and 58.30 ± 17.21 μg/L in control subjects ( P = 0.05). A positive correlation between PASI and sTNF-R1 was noticed ( r = 0.36, P = 0.04; r = 0.51 in group 1 and r = 0.18 in group 2). After 4 wk, almost complete remission of skin lesions was achieved in both groups, but the PASI score was higher in group 1 than in group 2 (4.30 ± 3.92 and 1.67 ± 1.17, respectively; P < 0.05). TNF-R1 levels were 1.81 ± 0.42 ng/mL in group 1 and 1.33 ± 0.40 ng/mL in group 2 ( P = 0.01), and the correlation between PASI score and TNF-R1 level became inverse ( r = −0.24 in group 1 and r = −0.59 in group 2). Se concentrations were 107.51 ± 18.08 μg/L in group 1 and 56.83 ± 15.32 μg/L in group 2 ( P < 0.01). Conclusions Increased level of sTNF-R1 may be an indicator of active psoriasis. Supplementation with selenomethionine was ineffective as adjuvant treatment in plaque psoriasis and may contribute to the maintenance of elevated TNF-R1 concentration in psoriasis patients despite the remission of skin lesions.